Monday, December 10, 2012

SHOULD DISADVANTAGED SCHOOL CHILDREN GET ADD MEDS?

Why not, if they truly have ADD? Of course, they should. That’s obvious. What is not so obvious is the recent stimulant medication use in disadvantaged children when they don’t have ADHD. A New York Times article, ”Pills for the Struggling Student,”(October 9, 2012) discusses the recent trend of prescribing stimulants to low-income students, WHETHER OR NOT THEY HAVE ADHD, to give them the same”edge” that more privileged students have. Let us not forget that Ritalin, Adderal and other stimulants can raise alertness in most people without a diagnosis of ADHD. (From my experience, high socioeconomic kids take stimulant meds whether or not they have ADHD). Let us not forget that stimulants can have major bad side effects.

The argument for low-income children seems cogent, but important considerations need to be stressed. First, there are many issues being ignored. Does the school or state have funding programs to enhance academic learning through special services such as tutoring? If not, the easy way out is just having Medicaid and other insurers pay for the use of a pill, so the schools need to make no adjustments. Medication has always been seen as the last resort after other educational and behavioral issues have been employed. Now it’s the first step in helping kids?

Second there are many factors impeding academic success such as learning disabilities, behavioral and emotional problems. Medication does not usually alter these issues. Also, there are parental management and other family factors that should be addressed, which medication per se will not impact.

So is our society going to PAY ATTENTION to other educational and societal changes to improve academics of struggling low- income children or just use pills?

Tuesday, August 7, 2012

ARE CAREER OPTIONS LIMITED FOR THE ADDer?

The answer is simply no, even if the ADDer has learning disabilities. If we look at the deficits, it is easy to say that the ADDer may not go far in his /her career. But what about the skills? I just met a few adult clients that have both ADD and LD, and could never read well. However, one has a high position in IT and is one of the computer experts in a university. He always thought he was “stupid”and struggled to get his GED. But afterward and several jobs later, his computer skills were recognized and he is one of the most valued employees in the university system. He is also has great mechanical and carpentry skills, and is creative in music. Another client with ADD has excellent interpersonal skills and manages client interactions in a big business.

I am ADD and have a Ph.D., but I can’t figure out how to open an umbrella, shut off the sleep dial on the radio, adjust a thermostat or fasten a necklace. My fine motor and mechanical skills are almost non-existent. Fortunately, I must have good analytical and interpersonal skills to be a clinical psychologist and ADD coach.

Monday, July 16, 2012

ADD AND NON-ADD: THE GOOD GRADE PILL - PART 3 | DIAGNOSING ADD AND GETTING MEDICATION

If you are a student who has ADD and really needs stimulant medication on a regular basis, you may find that that these medications are in short supply, since many non-ADD students are using them to acquire “laser focus” in studying. Where do all these non-ADD students get stimulants such as ADDerall? The NY Times article (cited in Part 1) indicates that students get them from friends who share them, or student sellers (which is a felony if reported). Many get legitimate prescriptions from their doctors or psychiatrists.

As a psychologist, psychiatrists have referred students for testing for ADD to me before they are willing to prescribe. What I have learned is that in particular, college students have mastered the “drill”. They have learned how to report relevant history and symptoms from their friends and the media.

How do I rule out non-ADD students? It is not easy. With high-schoolers, I can get corroborating data from parents, although now a number of parents will falsely report ADD behaviors, because they want their child to have accommodations and/ or an edge. The best a psychologist could do is probably conduct a comprehensive testing and look for inconsistencies, although students will soon find out the actual instruments used and become more savvy in responding, or go to another professional to get a diagnosis of ADD. So what is a realistic solution to this issue? Certainly not to put all students on ADDerall or other stimulants. In addition to the side effects mentioned earlier in Part II, it is important to note that many college students take other psychotropic medications at the same time they are asking for stimulants, which presents additional dangers.

Is the use of stimulant medication for getting an”edge” a value we want to support? Students are not only using these medications for late night focusing for exams, but during the time they take these exams as well.

I am ADHD and have to admit that in trying to write a book, I have difficulty sustaining attention, and have tried some of the stimulants at low doses. What happened? My heart rate was so rapid I had to discontinue them.